Recalls of home-based medical devices and defective single-use devices are the top two concerns on the Pennsylvania-based non-profit's top 10 technology hazards for 2023.
The growing popularity of smart home technology and home-based healthcare, including remote patient monitoring programs, means there are more medical devices in the home to oversee, either by the care team or the patent. That could lead to problems if the devices aren't working.
The challenge of identifying recalls for at-home medical devices tops the Top 10 Technology Hazards for 2023, an annual report issued by ECRI, a Pennsylvania-based non-profit focused on safety, quality, and cost-effectiveness in healthcare. Now in its 16th year, the report highlights the problems associated with healthcare technology, and spots trends in care delivery that might be catching both providers and patients by surprise.
With at-home medical devices, ECRI notes that patients using those devices at home might be the last to hear of a recall, and they might not understand what the recall means or how the address one.
"Device manufacturers seldom have direct communication with home care patients; and healthcare providers may not proactively contact patients about recalls," the report notes. "As a result, patients who use medical devices in the home may learn about a recall—and the steps needed to ensure safe use of the device—long after it was issued, and potentially from an unreliable source, such as a television commercial for a class-action lawsuit or through social media."
In addition, the recall notice might be filled with technical language that patients wouldn't understand clearly. They might not understand the risks involved with the device and continue using it.
"ECRI challenges manufacturers of medical devices that can be used outside the hospital environment to implement measures such as: providing users with easy-to-follow device registration instructions, writing simply worded recall notices, maintaining up-to-date databases of device distribution, and designating staff to ensuring that recalls reach home users," the report says.
Coming in second on the list is another growing trend in healthcare: The growing number of single-use medical devices, designed to be used once and then discarded. ECRI reports an "unacceptably high number of defective single-use medical devices," which can negatively impact patient care, lead to delays in care or treatment, and even harm patients.
"ECRI has received reports of cracked tubing and connectors; compromised sterility of needles, catheters, and procedure kits; and incorrect product labeling," the report notes. "These are just a few examples of product defects that can lead to waste, delays, incorrect treatment, healthcare-acquired infections, or other patient harm."
"ECRI is concerned that some device manufacturers are not making sufficient efforts to address the problem," it continues. "In fact, rather than seeing improvements over time, we’ve noticed a continuing increase in problem reports. ECRI urges manufacturers to take decisive steps to improve their quality control (QC) processes."
The rest of the list is as follows:
Inappropriate use of automated dispensing cabinet overrides.
Undetected venous needle dislodgement.
Failure to manage cybersecurity risks associated with cloud-based clinical systems.
Inflatable pressure infusers.
Confusion surrounding ventilator cleaning and disinfection requirements.
Common misconceptions about electrosurgery.
Overuse of cardiac telemetry.
Underreporting device-related issues.
Many of the items on this list were caused or exacerbated by the pandemic. Healthcare organizations struggled to maintain operations during the height of the COVID-19 crisis, and most are still dealing with stress, burnout, and staffing issues. In this environment, healthcare providers are more likely to consider work-arounds or bypassing established procedures to get something done, which could lead to unsafe or dangerous practices. It's inherent on management at this time to emphasize the importance of safety protocols.
At the same time, the report calls on the medical device industry to be more diligent.
"This year we’re extending a challenge to our industry colleagues," it notes. "We believe some of the hazards outlined in this report could be mitigated—and possibly even eliminated—by improved device designs or manufacturing practices. As a rule, an engineering solution that eliminates a hazard will always be preferable to a training solution that can only warn of a hazard. With the COVID-19 pandemic leaving healthcare facilities understaffed and healthcare workers overstressed, it’s more important than ever that medical technologies be designed in ways that help ensure their safe use."
ECRI also noted the trends it has spotted over the years in its reports that have led to industry-wide improvements. In the 1970s, it helped spur improvements to manual resuscitators to prevent inadequate lung inflation, and the 1980s saw a move to safer electrode connections for patient monitoring equipment to prevent electrocution.
In the 1990s, the reports pushed the industry to improve on bed safety to prevent entrapment and strangulations, as well as adding free-flow prevention mechanisms infusion pumps to prevent overmedication. And since 2000, the organization has prodded the industry to improve integration of drug libraries and infusion pumps to prevent drug dosing errors; improve CT scanner dose-control technologies to reduce radiation exposure; and improve endoscope reprocessing procedures and technologies to prevent cross-contamination.
The two are joining forces to create analytical technology that would help digital health studies attract a more diverse and representative patient population.
Duke University is joining forces with a California-based digital health firm to develop technology to measure health equity in clinical studies.
The North Carolina university's BIG IDEAs Lab is partnering with Evidation to create "an analytic structure to better predict study participation, adherence, and retention across racial and demographic lines," according to a press release.
While the COVID-19 pandemic saw a huge increase in the use of telehealth and digital health to boost access to care for underserved populations, it also trained the spotlight on social determinants of health and other barriers to care experienced by those groups.
This includes identifying non-clinical factors that hindered access to care and highlighting the lack of diversity in many clinical trials and healthcare studies. Studies indicate that racial and ethnic minorities only comprise 6% of clinical trial populations, yet account for 28% of the US population.
“As digital health research grows and evolves, we need to ensure that research populations are truly representative so that the technologies benefit everyone,” Jessilyn Dunn, PhD, an assistant professor of Biomedical Engineering at Duke University, said in the press release. “With our combined expertise, we aim to overcome some of the most persistent challenges in diversity and representation in digital health research.”
Duke's BIG IDEAs Lab uses biomedical and health data to create programs for the early detection, intervention, and prevention of disease. This includes projects that highlight "improved health monitoring through personalized, real-time risk classification and tailored, remote intervention strategies."
“Inclusion of underserved and underrepresented populations in research and study adherence among all groups are key challenges for enabling patient-centered healthcare," added Iredia M. Olaye, PhD, MSc, MHA, a member of Evidation and the Covered By Group investment and advisory firm. "Evidation has deep experience using advanced statistics and machine learning methodologies to rapidly connect with and understand diverse groups of individuals. Together, our work will equip researchers and providers with insights for more rigorous study design. If we can enable more equitable research, we can achieve more equitable care.”
The two organizations said the statistical framework, once created, will be made available to other digital health researchers.
A new messaging program embedded in the EHR is helping the hospital connect with parents who have avoided or skipped important medical check-ups for their children.
"There's a lot of value here in something that isn't that difficult to do," says William Brinkman, MD, Med, MSc, a board-certified pediatrician and director of the Division of General and Community Pediatrics at Cincinnati Children's.
Brinkman and Anne Berset, BA, a clinical research coordinator at Cincinnati Children's, used a messaging platform in a pilot project involving some 900 families of patients aged 6 to 17 years old, spread across three primary care practices in 2021. Using a platform that could deliver phone and text messages, they saw an almost 50% increase in scheduled well-child visits.
"There was a significant increase in the scheduling and completion of appointments after receiving the standard and tailored message compared with no message, indicating that simple outreach nudges via patient portal may prompt action," the two wrote in an analysis of the project published in November 2022 in the Journal of the American medical Association (JAMA). "The standard message group had higher rates of receiving COVID-19 vaccination within 8 weeks, suggesting that messages that reengage patients subsequently provide opportunities to promote healthy behaviors, such as vaccine acceptance."
William Brinkman, MD, Med, MSc, director of the Division of General and Community Pediatrics at Cincinnati Children's Hospital Medical Cener. Photo courtesy Cincinnati Children's.
Brinkman and Berset launched their program during the height of the COVID-19 pandemic, when access to healthcare services was in flux. Because of the virus, many healthcare organizations were shifting many in-person services to virtual platforms, and families were postponing or cancelling what they considered non-vital healthcare services. This included well-child visits, which plunged by at least 20% during the pandemic.
And while in-person healthcare appointments increased as the pandemic waned, Brinkman and Berset said parents still weren't bringing their children back to the office.
"Healthcare access was shifting all over the place," says Brinkman. "It became really glaringly obvious that something needed to be done" to boost interest and attendance.
It was also important, they said, to make parents aware of the value of a well-child visit.
"There's definitely a lot of education that needs to be done," says Berset. "Folks don't specifically know what a well-child visit is. They don't understand the value."
Anne Berset, BA, clinical research coordinator at Cincinnati Children's Hospital Medical Center. Photo courtesy Cincinnati Children's.
For their program, Brinkman and Berset chose a platform that could personalize a message to parents and send it via different modalities—text or phone—based on the recipient's preferences. They opted for this platform after studying other, similar programs and talking to patients and medical assistants who call and text families on a regular basis.
Brinkman says it's important to fit the messaging into a provider's regular workflow. This was done by going through the EHR and tacking the messages onto an already existing program—in this case a message regarding COVID-19 vaccinations. The message was personalized to include the patient's first name, reminded parents that their child was due for a well-child visit, and asked them to either call or use the patient portal to set up an appointment.
Berset says they learned through the program that some 44% of patients are using their patient portal.
"A lot of people were expecting that number to be higher, but that's OK," she says. "Finding out that the patient portal was successful in reaching patients was definitely rewarding for us. And it told us that we still have work to do."
They also found that this platform resonates with underserved populations, many of whom face barriers to accessing healthcare because they don't have the access, technology, or broadband capacity to attend virtual visits. But they do have smartphones.
Above all else, the project proved that simple, succinct phone and text messages are capable of nudging parents into scheduling well-child visits, and that a messaging platform can also bridge that gap between making that appointment and following through.
And that's important, particularly at this time. Brinkman notes that those well-child visits have picked up a variety of health concerns, both minor and serious, that weren't caught during the pandemic because of the skipped appointments.
"When [parents] came back in for the check-ups, there was a lot more to deal with," he says.
Brinkman and Berset are using the results of the pilot program to make it a permanent fixture in primary care and pediatric practices across the health system, as well as in HealthVine, the hospital's Medicaid accountable care organization, which serves more than 130,000 children.
Both see a lot of room for continued study. They'd like to test the value of different messages and modalities, as well as trying new strategies to boost patient portal adoption—which in turn may be an important step in boosting access to care for underserved populations.
"Using patient portals offers an additional layer in the approach to engage families, as outreach attempts need to be varied, especially in marginalized populations," they concluded in their study. "Future qualitative research should be done to (1) incorporate multiple communication modes, such as videos and storytelling; (2) offer and encourage choice; (3) develop patient-centered messages by cocreating with families; and (4) use interventions that leverage effective community partnerships and trust."
The New York-based health system is rolling out Northwell Health Pregnancy Chats, an AI-enhanced chatbot that can act as both a resource for important information about pregnancy and a care management tool that can alert care providers to an urgent health concern.
Northwell Health is launching a digital health platform aimed at addressing the nation's high maternal mortality rate.
The New York-based health system is rolling out Northwell Health Pregnancy Chats, an AI-enabled chatbot that can act as both an information resource and care management tool, alerting providers to any health concerns that require immediate follow-up.
“Northwell Health Pregnancy Chats are both extremely comprehensive and highly individualized and are designed to complement the interactions patients have with their providers,” Michael Nimaroff, MD, senior vice president of Northwell’s OB/GYN service line and chair of Obstetrics and Gynecology for North Shore University Hospital and Long Island Jewish Medical Center, said in a press release. “It’s a way to ensure women are never without support, whether they’re in a doctor’s office or in their own home.”
The chatbot targets a growing health concern in the US that has attracted the attention of health systems and the federal government. Roughly 26 of every 100,000 women die during childbirth, a rate much higher that many other countries and a particular concern among minorities, where the rate is even higher.
While the Biden-Harris Administration has targeted the issue in a Maternal Health Blueprint released in June 2022, many healthcare organizations are using digital health tools like mHealth apps and remote patient monitoring programs to connect with mothers-to-be at home and monitor them through their pregnancy. Many of these programs continue after childbirth, to monitor the baby's health and the mother's well-being.
“Far too many pregnant and birthing people in this country suffer harm or even die because of problems that are entirely preventable," Dawnette Lewis, MD, MPH, director of the Center for Maternal Health, said in the press release. "Northwell is committed to doing whatever is necessary to reduce those risks. By bringing together high-tech innovation and high-touch clinical care, the Northwell Health Pregnancy Chats will help keep women and babies safe.”
Developed in a partnership with Portland-based digital health company Conversa Health, which is now part of Amwell, the chatbot was deployed in a pilot program and used by some 1,632 patients. The program helped to identify several urgent health problems, including severe preeclampsia and behavioral health concerns, and was positively received by 96% of the users.
The no-cost digital health tool, accessible via smartphones and other mobile devices, will eventually be offered to women receiving pregnancy care throughout Northwell Health's coverage area, according to the health system.
The state's Medicaid program is partnering with digital health company Pear Therapeutics on the precision digital therapeutics program aimed at treating residents in 24 counties who are living with stimulant use disorder.
The state of California is launching a precision digital therapeutics program aimed at helping people living with substance use disorders.
The California Department of Health Care Services (DHCS) is partnering with digital health company Pear Therapeutics to support the state's Recovery Incentives program, which was launched in 2022. The contingency management (CM) program, operated through the state's Medi-Cal Medicaid department, targets those dealing with stimulant use disorder by offering motivational incentives and tracking behaviors.
Some 24 California counties will take part in the program.
"Participating Drug Medi-Cal Organized Delivery System (DMC-ODS) counties will launch the CM benefit in the first quarter of 2023, in accordance with approval from the Centers for Medicare & Medicaid Services as part of the CalAIM 1115 Demonstration," DHCS reports on its website. "Eligible Medi-Cal beneficiaries will participate in a structured 24-week outpatient program, followed by six or more months of additional recovery support services. Individuals will be able to earn motivational incentives in the form of low-denomination gift cards, with a retail value determined per treatment episode."
Pear Therapeutics, based in Boston, develops digital therapeutic treatments, or software-based tools designed to allow providers and patients to track engagement and adherence and target behaviors through incentives and other methods. An important part of the process is the use of digital health to track patients and enable on-demand collaboration and long-term engagement with care providers.
Advocates, including the Digital Therapeutics Alliance, say the digital health platform is effective and can replace traditional medication-based treatments.
Hinge Health, which focuses on virtual physical therapy for businesses and health plans, is adding in-person visits. It's a nod to the growing popularity of hybrid healthcare.
A digital health company specializing in physical therapy is adding house calls to its portfolio.
San Francisco-based Hinge Health has unveiled a physical therapy house call service aimed at improving the long-term value of virtual care. The service, which will launch in Chicago before a nationwide rollout, aims to complement the virtual care platform by giving patients in-person evaluations.
“As the market leader in MSK [musculoskeletal] care, it’s incumbent on us to transform the member experience by challenging the status quo,” Daniel Perez, the company's co-founder and CEO, said in a press release. “Integrating digital and in-person care is a leap forward in bridging care gaps and reimagining a healthcare model that works for everyone.”
The announcement follows a post-pandemic trend in the healthcare industry in combining virtual and in-person services on a hybrid platform. While telehealth and virtual care saw huge increases in use during the height of the COVID-19 crisis, the pendulum has since swung back in the other direction, with patients often asking for a return to office-based care.
Company officials say the virtual platform improves access to healthcare services, allowing patients to receive physical therapy in the comfort of their own homes and on their own schedules. But many patients, especially those with back, joint, or muscle pain, would also benefit from in-person evaluations that can be more thorough and comprehensive than virtual consults.
The company, which contracts with businesses and health plans, says the house call service will include physical and environmental assessments, hands-on therapy, and guided digital setup services and can be scheduled the next day, evenings, or weekends.
The strategy might appeal not only to those who prefer virtual services, but also to that percentage of consumers who are hesitant to try virtual care or prefer in-person care.
The two San Diego-based healthcare organizations have forged a three-year deal to develop an integrated care management plan for seniors, incorporating everything from primary care to inpatient services to home-based care.
Two San Diego-based healthcare organizations are joining forces to develop an integrated care management model for the nation's growing senior population.
Sharp Memorial Hospital and West Health have entered into a three-year deal to create a "model of excellence for older-adult care," which would bring together best practices for everything from primary care to inpatient services to home-based care.
“In collaboration with Sharp Memorial Hospital, we’re bringing together incredible advancements in geriatric care that have, until now, been largely siloed within medical specialties such as emergency medicine or surgery,” West Health Chair and CEO Shelley Lyford said in a press release. “By coordinating senior-friendly care across the entire health system, we’ll be amplifying those advancements and helping older patients achieve the best-possible healthcare experience.”
“Our population is rapidly shifting; by 2030, the number of older adults in San Diego will be 80 percent higher than the decade earlier,” added Tim Smith, Sharp Memorial's senior vice president and CEO. “These are valued members of our community who deserve the best-possible care. But the needs of older patients are quite different than those of the average adult, and that’s what’s driving our commitment to create new and better standards of care.”
The growing senior population is expected to strain the resources of the nation's healthcare industry, which is already struggling with staff and provider shortages amid a bad economy. In addition, many seniors are looking to remain in their homes for a longer time, rather than move in with family or into senior care facilities, putting pressure on healthcare to improve home-based monitoring and care management services.
Some health systems, like Dartmouth Health in New Hampshire, have developed specific geriatric care programs, and the American College of Surgeons offers certification for geriatric surgery. Sharp Memorial and West Health, a collection of non-profits focused on senior care services and successful aging, want to create a platform of care management that eliminates siloed services and gives healthcare organizations a master plan for treating seniors. It would include care coordination as well as senior-specific programs.
“West Health and Sharp Memorial are reimagining what successful system-wide care can look like for older-adult patients, and we’ll share the model with the world in the hopes others will make the same transformation,” Lyford said in the press release. “Already, hospital systems are seeing the positive impact of geriatric specialty care in emergency settings and operating rooms. Just think of the impact when that level of care extends throughout the entire system in an intentional and coordinated manner.”
“Injuries and illnesses in older patients can have immediate, permanent consequences on their independence and mobility,” added Diane Wintz, MD, a Sharp-affiliated critical care specialist and medical director of the Trauma Program at Sharp Memorial Hospital who helped forge the alliance with West Health. “We see the best results when there’s an exceptional level of teamwork across departments and specialties. We want to see emergency teams, surgeons, pharmacists, and primary care providers taking collaboration to a whole new level for our older patients.”
Healthcare executives showed up to CES to talk about the unique value of digital health and look for diamonds in the rough.
Jason Swoboda came to CES 2023 eager to see the newest in consumer technologies. But while others were wowed by the color-changing cars, mega-screen TVs, and interactive games, the director of innovation at Tampa General Hospital had his sights set on digital health.
"I'm thinking about the patient room of the future," he said.
Swoboda was one of a growing number of healthcare executives to brave the crowds in Las Vegas and attend an event that healthcare had for many years kept at arm's length. Where health systems once regarded consumer-facing technology as a fashionable fad without clinical relevance, they're now taking a closer look at tools and platforms that could add value to the patient experience.
And CES has taken notice as well. What once was contained in a tiny corner of one conference hall now has its own dedicated digital health section, where Abbott was showing off the latest in testing tech, Withings had a collection of wearables on display, MedWand was demonstrating its home-based digital health tool, and Vivoo was offering up a smart toilet and home urine-testing platform. Other examples could be found at the nearby Venetian resort and conference center, where healthcare played an integral role in Parks Associates' Connections Summit.
Rene Quashie, vice president of digital health for the Consumer Technology Association, which produces the CES show, said the CTA's VIP tour for healthcare executives was a busy affair, and executives from healthcare organizations took part in several digital health panels, including a digital health keynote that focused on the evolution of hybrid care.
In short, healthcare organizations are interested in consumer-facing digital health as they maneuver the long, slow path from fee-for-service to value-based healthcare. They're interested in technologies that can engage the patient and develop a rapport that affects not only clinical care, but the patient's entire healthcare journey.
For Swoboda, this means finding the innovative new devices and platforms that can improve care at the bedside as he looks to redesign the inpatient experience. It also means checking out the fast-growing smart home technologies that could play a part in Tampa General's remote patient monitoring and hospital at home programs, both existing and in the future.
"Connecting to the home," he says, will be a key element of Tampa General's value-based care strategy, as more non-acute care shifts from the inpatient setting to virtual care platforms. That means finding the right technologies and channels to gather and analyze data from other settings, such as the home or office, and collaborate with patients on care management.
CES offers a glimpse of those technologies, including sensor arrays that integrate with beds, toilets, even refrigerators, and digital health platforms that can facilitate behavioral healthcare, test for viruses, scan blood or urine for certain chemicals, or even help men with their, ahem, sexual needs.
To be sure, CES is filled with technology that has nothing to be with healthcare, but it represents the latest in innovative ideas. Augmented and virtual reality first saw the light of day at this show, along with smart home products, drones, 3D printing, avatars, AI, and robots. Alongside the aforementioned smart toilets (for cats as well as humans), some relatively new ideas getting the spotlight this year included digital twin technology, light-based treatments, sensor-embedded jewelry and shoes, and smart strollers and car seats.
Most of these technologies won’t be found at the traditional healthcare conferences hosted by HIMSS, HLTH, ViVE, or the American Telemedicine Association, and that's fine with Swoboda. Just as healthcare has been pushed to "think outside the box" in terms of innovation, he says he's interested in ideas that haven't yet reached the mainstream but offer new approaches to old problems.
"We have a strategic imperative [that focuses on] consumerism," he says. And that means looking at the healthcare system from the consumer's perspective.
That sentiment extends to the vendors as well. It's what brought Teladoc Health, one of the biggest names in the telehealth field, to CES, where they announced the launch of a new digital health app aimed at "enabling personalized whole-person care to individuals." That includes access to primary care, mental health, and chronic care management services in both English and Spanish.
Shayan Vyas, MD, MBA, Teladoc Health's senior vice president and chief medical officer, said health systems are certainly interested in the consumer health space, but they want one single point of entry, rather than a collection of disparate apps, tools, or platforms. Many are looking for help managing that connected health approach.
"The hospital itself is not the most efficient place right now," he said, watching attendees surge into the CES events at the Venetian on a Thursday morning. "They're focusing on maximizing the investment in their EMRs and they need help" creating a unified platform that incorporates digital health, one that can be scaled outwards.
Indeed, health systems are plagued by plunging operating margins and growing staff and provider shortages, and they need all the help they can get. At the same time, they're not going to spend a lot of money on new or unproven technologies. They're looking for solutions that not only ease their pain but are sustainable either through ROI or growth.
"It's all about maximizing investments," Vyas reiterated.
And that's what Swoboda is looking for as well. Amid all the booths offering nice-to-have solutions or conveniences, he's looking for technology that will make a difference in the patient experience and push Tampa General closer to value-based care.
Healthcare executives speaking at CES 2023 this week in Las Vegas say the industry has to evolve to keep up with the times. How it deals with collecting, analyzing and using data may be the key to that evolution.
Healthcare organizations may have a hard time figuring out what to do with consumer technology, especially in this time of tight profit margins, but there's no denying that the data coming from these tools and platforms will have a significant impact on the future of healthcare.
And at CES 2023 this week in Las Vegas, that's what the experts were talking about.
"Using data to really leverage the journey of healthcare is very important," said Susan Turney, MD, MS, FACP, FACPME, CEO of Wisconsin's Marshfield Clinic Health System.
"When you start getting that data together with making it easier and seamless, that's [the goal] we have to get to," added Stephen Klasko, MD, MBA, former president and CEO of Thomas Jefferson University and Jefferson Health and now an executive in residence at General Catalyst.
Turney and Klasko took part in a high-profile panel on the first day of the sprawling consumer electronics show. Titled "The Future of Care in America: A New Hybrid Model," it included Carlos Nunez, MD, chief medical officer for ResMed, Anne Docimo, MD, UnitedHealthcare's chief medical officer, and Vidya Raman-Tangella, MD, chief medical officer of Teladoc Health.
The panel's topic offered ample evidence of the impact that digital health is having on healthcare, and was underscored by the size and breadth of digital health and healthcare companies and products at CES 2023. And underneath all those tools and technologies, from smart toilets to mobile health apps to companion robots to digital twins to AI and VR and AR, is data. It's what everything collects, analyzes and uses.
Healthcare has been slow to catch on to the value of digital health and data, and the panel was on hand to emphasize that this is how the industry must evolve to take in value-based care. Health systems and hospitals that fail to evolve in this manner risk losing their patients to Amazon, Walgreen's, CVS, and the health plans and health systems that de embrace digital health data.
Nunez referenced a recent Intel report that estimated healthcare data makes up one third of all the data collected around the globe, yet roughly 95% of that data isn't being used. It's sitting out there in many different forms and locations, offering insights into how health and wellness can be measured and improved for every individual.
And yet healthcare hasn't yet caught on.
"The fact that we define hospitals as where we fail to keep people healthy is wrong," Klasko said.
So healthcare needs to evolve to collect and use that data. Klasko pointed out that this evolution is being defined by new partnerships that embrace digital health, with parties that might not have had a presence in healthcare before. Hospitals are joining forces with AI companies, food distribution and nutrition companies, and others to identify and address gaps in care and improve not only clinical outcomes but health and wellness.
"How do we redefine ourselves in a radically collaborative way?" he asked.
Docimo pointed out that a key to harnessing and using data will be finding the right platform, a challenge right now with so many EHRs out there unable to work with each other.
"What we have to get to is a common platform so we can unify that data," she said.
And that's where healthcare should and will be headed.
Once considered the health plan for privileged people, concierge medicine is enjoying a rebirth, using technology and data to create 'personalized, proactive, and preventive' care for anyone who needs it.
The evolution of personalized healthcare is giving new meaning to concierge services. What once was a platform for the rich and famous now offers precision healthcare, including chronic care management and health and wellness services, for anyone.
"We're optimizing health for everyone," says Rakesh Suri, MD, D.Phil., president and chief medical officer of Fountain Life, a Florida-based provider of "predictive, preventative, and personalized" care services that aims to create an international chain of healthcare centers. "We're focusing on the healthy years of life."
Concierge medicine encompasses a variety of terms, like boutique medicine, retainer-based medicine, platinum practice, and direct primary care. Generally, the organization contracts with a consumer or group, such as a company or health plan, for a fee to provide healthcare services.
Some health systems are launching their own concierge medicine programs. Tampa General Hospital recently opened TGH Concierge Health to offer residents of Florida's Palm Beach County and Treasure Coast personalized access to primary care services.
“If someone isn’t feeling well, they don’t want to wait for the next available appointment,” Laurie P. Rothman, MD, the first doctor to join the new program, said in a press release. “In addition to more time, my patients will also have increased access. If there is an emergency or they are sick, and it’s 9 o’clock at night, they can call me or text me and we’ll be able to talk it through and make a plan.”
But while some see this popular trend as paying for access to healthcare, others see the opportunity to create programs for personalized care that go beyond what a doctor or hospital can do.
Suri, who spent 12 years at The Mayo Clinic and seven years at The Cleveland Clinic, most recently as chief executive officer of its Abu Dhabi site, before joining Fountain Life in October 2022, says the concept of concierge care has undergone a make-over, so much so that he doesn't like that term. What Fountain Life and other sin this space are doing, he says, is developing "personalized, proactive, and preventive care."
Rakesh Suri, MD, D.Phil, president and chief medical officer at Fountain Life. Photo courtesy Fountain Life.
"We're taking concierge care and advancing it upstream," he says. Traditional health systems "focus more on care of the unwell. We start with the healthy person and use advanced diagnostics to focus on preventive health … [and] prevent catastrophic events."
Organizations like Fountain Life may very well fit into the health system of the future, where hospitals would evolve to focus on the most critical cases and medical practices, retail healthcare sites would take care of episodic, not-acute needs, and medical practices, specialists, and other clinics would focus more on ongoing health management.
Suri says Fountain Life fits into that ecosystem, and would form partnerships with health systems and other organizations to optimize a patient's healthcare journey. New technology, like digital health and AI, are being used not only to help people deal with ongoing health concerns, but identify and manage future issues.
"It's not the newest, brightest shiny object alone," he says, but an integrated and scalable platform that, much like the design of a value-based care system, focuses on overall health rather than periodic issues. In doing so, they're focusing on "the pre-symptomatic population."
"We are and will continue to be on the cutting edge of innovation," he says. "And it's all about the data. All of this is poured into a very sophisticated version of a data lake."
The company's business plan sounds very much like a concierge medicine organization, with high-tech, attractive centers now located in Naples, Florida; White Plains, New York; and Dallas. The company's website lists future centers in Lake Nona, Florida; Santa Monica, California; Toronto; Dubai; and New Delhi, India.
Suri says the company's plan is to create a network of clinics that collaborate with local health systems and providers.
"Mainstream health right now is reactive, and perhaps unsustainable," he says. "The escalating cost of healthcare is straining [traditional] health systems, who are operating on razor-thin margins. On top of that, insurance companies are asking providers to take on more risk, and corporate entities are seeing their employees ask to provide healthcare services for them."
